Korean J Hematol.  2007 Dec;42(4):382-391. 10.5045/kjh.2007.42.4.382.

Final Height of Children after Stem Cell Transplantation

• Park EY
• Baek HJ
• Han DK
• Lee SJ
• Cho YK
• Kim YO
• Kim CJ
• Kook H
• Woo YJ
• Hwang TJ

• KMID: 2252224
• DOI: http://doi.org/10.5045/kjh.2007.42.4.382

Abstract

BACKGROUND: Growth impairment is a common complication after hematopoietic stem cell transplantation (SCT). The aim of this study was to evaluate the final adult height of patients who underwent SCT in childhood and to identify the factors that influence long-term growth in these patients.
METHODS
A retrospective review of 15 children who underwent SCT before puberty at Chonnam National University Hospital and reached final adult height was undertaken. To assess the severity of height reduction and to monitor the height changes longitudinally, height measurements of each patient both at the time of SCT and the final height were expressed as the height standard deviation score (SDS).
RESULTS
Seven children were males and eight were females with a median age of 12.8+/-2.4 years (range, 6.3~14.7) at SCT. The median follow-up period was 7.1+/-2.0 years (range, 4.5~11.1) and their final height was achieved at 18.1+/-1.5 years (range, 17.0~21.8). Final height SDS values were within normal for the healthy population in all except two who had short stature (below -2.0 SDS). No patient achieved height values greater than +2.0 SDS. The final height SDS value (-0.5+/-1.2) was not decreased from the height SDS value at SCT (-0.8+/-0.8). The younger age group at SCT (6.1~10.0 years, n=5) showed significantly lower final height SDS and greater Delta SDS than the older age group (10.1~15.0 years, n=10) (-1.5+/- 0.6 vs. -0.1+/-1.1, P<.05; -1.2+/-0.7 vs. 0.5+/-0.8, P<.05, respectively). The irradiation-based conditioning (n=6) had negative effects on the Delta SDS (P>.05) and the final height SDS (P<.05). The gender, type of disease, donor type or the presence of chronic graft-versus-host disease did not influence height.
CONCLUSION
Growth impairment may be encountered in children after SCT. A younger age at transplant and irradiation were found to be factors associated with reduced final height. However, most patients (13/15) reached a final adult height within normal limits for the general healthy population.

Keyword

Stem cell transplantation; Fianl adult height; Growth impairment; Irradiation; Children

MeSH Terms

Adolescent
Adult
Child*
Female
Follow-Up Studies
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Jeollanam-do
Male
Puberty
Retrospective Studies
Stem Cell Transplantation*
Stem Cells*
Tissue Donors

Figure

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  Fig. 1 Comparison between mid-parental height and final height. (A) Male, (B) Female.

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  Fig. 2 Final SDS (SDS at final height) and ΔSDS (final height SDS-SDS at transplantation) in different age groups. Younger age group (＜10 years) shows lower final and ΔSDS than older group (＞10 years).

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  Fig. 3 ΔSDS (final height SDS-SDS at transplantation) in different irradiation groups. (A) Irradiation group shows lower ΔSDS than non-irradiation group. (B) ΔSDS is the lowest in patients who received TBI, followed by TLI group and no irradiation group.

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